Caring for Thai Traumatic Brain Injury Survivors in a Transitional Period: What Are the Barriers?

Abstract

Objective: We aimed to explore the situations and experiences of Thai traumatic brain injury (TBI) caregivers and nurses who care for TBI patients during their transition from hospital to home. Material and Methods: A descriptive qualitative study was conducted in a tertiary hospital, in Songkhla province, Thailand. Five TBI family caregivers and nine nurses, who cared for TBI patients from admission to discharge, were selected for in-depth interviews and focus group discussions. Reviews of existing documents related to caring for someone during a transition period; such as: the caregiver’s booklet manual, nurse’s guideline, discharge education, and the service plan were also analyzed. Content analysis was used to explore caring for someone during a TBI situation, within the Thai context. Results: The findings revealed six main barriers in the current care system for TBI caregivers and nurses. These included: (1) inadequate discharge teaching information, (2) less time in caregiver’s supervision and support, (3) lack of a comprehensive discharge plan, (4) lack of coordination and communication in follow-up care, (5) less confidence in providing care without support at home, and (6) poor availability of resources and time for consultation. Conclusion: Caregivers require more information and supportive care in order to enhance their adaptation in taking care of TBI patients in the long term. Developing a tele-nursing based caregiver transitional support program among TBI caregivers is suggested.

Feasibility Study Of M-Health Transition Care Program For Traumatic Brain Injury Caregivers

“…Continuity of care in patients with TBI and caregivers needs particular attention in Indonesia. For patients with moderate and severe TBI who require long-term care, the continuity program of transitional care is a crucial component bridging the in-hospital care program and out-of-hospital follow-up care (Siripituphum et al, 2020). Research also proves that this program effectively increases the caregiver's ability to carry out care, improves the caregiver's psychological condition, and reduces the incidence of re-hospitalization (Shahrokhi et al, 2018;Stiekema et al, 2020) In practice, in Indonesia, transitional care services for patients with TBI have not been developed.…”

Neuromonitoring in neurocritical care for traumatic brain injury in the Thai context

“…1). The main objectives of performing systematic neuro-critical care in Thailand, together with neuro-monitoring, were to optimize brain oxygen delivery, improve practical applications, and provide education to encourage humanization in neurotrauma and neurocritical care, education, and changing the approach-promoting teamwork and multidisciplinary techniques, verifying patient care, caregiver education, and strengthening and long-term follow-up on the impact of neurocritical care patients on the quality of life of the patients, their families, and their social circle [3].…”

“…The characteristics of TBI patients when performing a computer tomography (CT) scan were a 30% abnormal CT scan and 3-5% surgical indication that surgery was needed [2]. After following these patients for 6 months, we found that 61% of patients with moderate to severe TBI experienced a disability, a high rank in the volume of patients, mortality, and a combination of both death and disability [3].…”

Current status of post-traumatic brain injury rehabilitation care in LMI Southeast Asian Countries: A mini systematic review

“…Furthermore, caregivers of patients with TBI, particularly family members, should also be equally educated on the positive impact of rehabilitation care post-injury. In a study in Thailand, it was highlighted that a proper discharge plan was not available for the reference of the family/caregivers in the continuity of post-TBI care, which may negatively affect the patient's health condition and rehabilitation outcome (Siripituphum et al, 2020). In addition, negative events, including non-sensitive or disrespectful interactions in the healthcare settings experienced by the patients and caregivers, may affect their introduction and trust in healthcare providers during rehabilitation care (Bright et al, 2018).…”